Blood Pressure Variability in Fabry Disease Patients

Nephron ◽  
2021 ◽  
pp. 1-8
Author(s):  
Mevlut Tamer Dincer ◽  
Seyda Gul Ozcan ◽  
Baris Ikitimur ◽  
Ertugrul Kiykim ◽  
Alev Bakir ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Fabry Disease ◽  
Blood Pressure Monitoring ◽  
Lysosomal Storage ◽  
Control Groups ◽  
Adult Age ◽  
Average Real Variability ◽  
Reverse Dipping

<b><i>Introduction:</i></b> Fabry disease is a rare metabolic, multisystemic, and X-linked lysosomal storage disorder. The involvement of the autonomic nervous system is well defined; however, data on the variability of the blood pressure (BP) and heart rate in Fabry disease are largely missing. In this study, we aimed to examine the circadian variations of BP and heart rate variability in Fabry disease patients. <b><i>Methods:</i></b> We recruited 31 consecutive adult (age &#x3e;18 years) Fabry disease patients (16 males and 15 females) who were regularly followed up in our outpatient clinic between July 2019 and March 2020. We performed ambulatory blood pressure monitoring and echocardiography in all patients. We used standard deviation (SD), coefficient of variation (CV), and average real variability as the measures of variability. We constructed 2 control groups for propensity score matching using age, sex, and eGFR parameters in the first group and adding antihypertensive drug use to the above parameters in the second group. <b><i>Results:</i></b> All BP measurements were significantly lower in the FD group compared to that of the control groups, except the nighttime systolic BP. Regarding nondipping and reverse dipping statuses, FD patients and controls were similar. We found that none of the BP variability measures were higher in FD patients. Regarding heart rate variability data, both the nighttime SD and CV were significantly lower in FD patients compared to those of the controls. <b><i>Conclusion:</i></b> A decrease in heart rate variability, rather than an increase in BP variability, might be an early marker of autonomic involvement in FD.

scholarly journals Increase of Short-Term Heart Rate Variability Induced by Blood Pressure Measurements during Ambulatory Blood Pressure Monitoring

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Attila Frigy ◽  
Annamária Magdás ◽  
Victor-Dan Moga ◽  
Ioana Georgiana Coteț ◽  
Miklós Kozlovszky ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Ambulatory Blood Pressure ◽  
Pressure Measurement ◽  
Blood Pressure Monitoring ◽  
Blood Pressure Measurement ◽  
Pressure Measurements ◽  
Pressure Monitoring ◽  
Short Term

Objective.The possible effect of blood pressure measurements per se on heart rate variability (HRV) was studied in the setting of concomitant ambulatory blood pressure monitoring (ABPM) and Holter ECG monitoring (HM).Methods.In 25 hypertensive patients (14 women and 11 men, mean age: 58.1 years), 24-hour combined ABPM and HM were performed. For every blood pressure measurement, 2-minute ECG segments (before, during, and after measurement) were analyzed to obtain time domain parameters of HRV: SDNN and rMSSD. Mean of normal RR intervals (MNN), SDNN/MNN, and rMSSD/MNN were calculated, too. Parameter variations related to blood pressure measurements were analyzed using one-way ANOVA with multiple comparisons.Results.2281 measurements (1518 during the day and 763 during the night) were included in the analysis. Both SDNN and SDNN/MNN had a constant (the same for 24-hour, daytime, and nighttime values) and significant change related to blood pressure measurements: an increase during measurements and a decrease after them (p<0.01for any variation).Conclusion.In the setting of combined ABPM and HM, the blood pressure measurement itself produces an increase in short-term heart rate variability. Clarifying the physiological basis and the possible clinical value of this phenomenon needs further studies.

Abstract P125: Performance of Ambulatory Blood Pressure Monitoring in Predicting Autonomic Dysfunction

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Abhilash Koratala ◽  
Kawther F Alquadan ◽  
Abutaleb A Ejaz
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Ambulatory Blood Pressure Monitoring ◽  
Autonomic Dysfunction ◽  
Ambulatory Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Postprandial Hypotension ◽  
Increased Risk

Background: We investigated the predictive performance of orthostatic hypotension (OH) and ambulatory blood pressure monitoring (ABP) to predict autonomic dysfunction. Methods: In this retrospective analysis, statistical associations among the candidate variables were investigated and comparisons of predictive performances were performed using Receiver Operating Characteristics (ROC) curves. Results: Ninety-four patients were included for analysis. No significant correlations could be demonstrated between OH and components of ABP (reversal of circadian pattern, postprandial hypotension and heart rate variability), nor between OH and autonomic reflex screen. Reversal of circadian pattern did not demonstrate significant correlation (r= 0.12, p=0.237) with autonomic reflex screen, but postprandial hypotension (r=0.39, p=0.003) and heart rate variability (r=0.27, p=0.009) demonstrated significant correlations. Postprandial hypotension was associated with a five-fold (OR 4.83, CI95% 1.6 - 14.4, p=0.005) increased risk and heart rate variability with a four-fold (OR 3.75, CI95% 1.3-10.6, p=0.013) increased risk for autonomic dysfunction. Per ROC curves, heart rate variability (0.671, CI 95% 0.53-0.81, p=0.025) and postprandial hypotension (0.668, CI 95% 0.52-0.72, p=0.027) were among the best predictors of autonomic dysfunction in routine clinical practice. Conclusions: Postprandial hypotension and heart rate variability on ambulatory blood pressure monitoring are strong predictors of autonomic dysfunction in routine clinical practice.

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